Avaliação da eficácia de doses repetidas de nitroprussiato de sódio no tratamento da esquizofrenia resistente: um estudo duplo-cego, randomizado, controlado por placebo

• Ano de defesa: 2020
• Autor(a) principal: Adelino, Marcelo Pinheiro Machado [UNIFESP]
• Orientador(a): Lacerda, Acioly Luiz Tavares de [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/48912/001300002wghb
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Esquizofrenia resistente; Tratamento; Nitroprussiato de sódio; Óxido nítrico; Glutamato; Antipsicóticos; Escalas de graduação psiquiátrica; Método duplo-cego; Ensaio clínico controlado aleatório
• Palavras-chave em Inglês: Resistant schizophrenia; Treatment; Sodium nitroprusside; Nitric oxide; Glutamate; Antipsychotic agents; Psychiatric status rating scales; Double-blind method; Randomized controlled trial
• Link de acesso: https://hdl.handle.net/11600/64475; https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=9702443

In present study, we evaluated the efficacy of repeated-dose sodium nitroprusside (SNP) in treatment-resistant schizophrenia. Methods: This was a double-blind, randomized, placebo-controlled trial. Twenty DSM-IV schizophrenia subjects, aged 18-60 years, with a history of nonresponse to ≥2 trials of antipsychotics used in adequate dose and duration (≥6 weeks) were enrolled. Subjects received SNP or placebo 4-hour infusions at 0.5 μg/kg/min. A total of 4 infusions and 4 follow-up evaluations, with an interval of 2 weeks, were performed. Severity of symptoms was assessed by using Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS-18) and Clinical Global Impression (CGI) scales. Results: SNP and placebo groups did not differ at baseline or in change from baseline for PANSS-total F3.597, 64.748=0.398; p=0.790), PANSS-positive (F2.898, 52.167=0.509; p=0.672), PANSS general (F3.302, 59.431=0.243; p=0.983), BPRS (F4.312, 77.615=0.143; p=0.946), or CGI (F3.841, 69.131=1.096; p=0.364) scores. SNP was well tolerated and showed a good safety profile. Conclusion: Although preliminary, the present findings suggest that SNP is not efficacious in TRS, reinforcing previous studies that have not demonstrated symptom improvement in chronic schizophrenia subjects. At this time, it is conceivable to speculate that efficacy of SNP might be restricted to early stages of disease.